Kobe Journal of Medical Sciences最新文献_第5页

Lived Bodily Experience of Worsening Heart Failure from Acute Exacerbation to Recovery: A Phenomenological Study. 从急性加重到恢复期心力衰竭恶化的身体体验：现象学研究

Kobe Journal of Medical Sciences Pub Date : 2024-06-03 DOI: 10.24546/0100489736

Junko Shogaki, Atsuko Fukuda, Shoichi Matsuba, Nao Saito, Ikuko Miyawaki

{"title":"Lived Bodily Experience of Worsening Heart Failure from Acute Exacerbation to Recovery: A Phenomenological Study.","authors":"Junko Shogaki, Atsuko Fukuda, Shoichi Matsuba, Nao Saito, Ikuko Miyawaki","doi":"10.24546/0100489736","DOIUrl":"10.24546/0100489736","url":null,"abstract":"Patients with heart failure have difficulty recognizing and identifying changes in bodily sensations, despite the importance of symptom monitoring. The way patients with heart failure experience their bodies from exacerbation to recovery is poorly understood. We aimed to describe the lived bodily experience of heart failure from exacerbation to recovery. Participatory observations and interviews were conducted in seven patients admitted to the intensive care unit with worsening heart failure. Benner's interpretive phenomenology was used for analysis. Four major themes were identified: a non-functional body becomes the central concern and an object; being conscious of bodily changes before hospitalization when asked; the central concern shifted to daily life and the body becomes the background; and having a feeling of death in the body that no longer functions or a weakened body after recovery. This study found that patients with heart failure were conscious and concerned about their bodies changing as they underwent rapid changes during exacerbations and recovery. In addition, immediately after their bodies recovered and until they were discharged from the hospital, they looked toward their daily lives through their bodily experiences during heart failure exacerbation. The lived bodily experience of heart failure, which is less conscious in daily life, is made conscious through storytelling in the period immediately following recovery from an acute exacerbation and can be the basis for subsequent self-care exploration.","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"70 2","pages":"E46-E55"},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Case of Olfactory Neuroblastoma Developing Bilateral Retropharyngeal Lymph Node Metastasis 14-years After Skull Base Surgery. 一例嗅神经母细胞瘤患者在颅底手术 14 年后出现双侧咽后淋巴结转移。

Kobe Journal of Medical Sciences Pub Date : 2024-06-03 DOI: 10.24546/0100489917

Marie Mizumoto, Tatsuya Furukawa, Mitsuko Yui, Keisuke Iritani, Shun Tatehara, Go Inokuchi, Masanori Teshima, Hirotaka Shinomiya, Hidehito Kimura, Naomi Kiyota, Ryohei Sasaki, Ken-Ichi Nibu

{"title":"A Case of Olfactory Neuroblastoma Developing Bilateral Retropharyngeal Lymph Node Metastasis 14-years After Skull Base Surgery.","authors":"Marie Mizumoto, Tatsuya Furukawa, Mitsuko Yui, Keisuke Iritani, Shun Tatehara, Go Inokuchi, Masanori Teshima, Hirotaka Shinomiya, Hidehito Kimura, Naomi Kiyota, Ryohei Sasaki, Ken-Ichi Nibu","doi":"10.24546/0100489917","DOIUrl":"10.24546/0100489917","url":null,"abstract":"Olfactory neuroblastoma (ONB) is an uncommon malignant tumor and is usually treated by a multidisciplinary approach includes surgery, radiotherapy, and chemotherapy. A 62 years-old male had a tumor in the nasal cavity and diagnosed as ONB with Kadish A stage. Anterior skull base surgery was performed as radical treatment. Since the surgical margin was negative, no postoperative radiotherapy was administered. 14 years after the surgery, bilateral otitis media with effusion (OME) was occurred, we found the recurrence tumor at bilateral retropharyngeal lymph node (RPLN) which surrounded the internal carotid arteries. Since these were unresectable, we planned chemoradiotherapy which was 70Gy of intensity modulated radiotherapy combined with two courses of carboplatin and etoposide. The tumor volume was reduced and bilateral OME were improved. He has been alive for 3 years after salvage treatment. Although ONB has a relatively good prognosis, it is known to often cause cervical lymph node metastasis. Grades III and IV of Hyams classification are considered high risk. This case, initial tumor was limited in the nasal cavity and its clinical classification was early stage, but Hyams classification was grade III. In reference to this case, considering that RPLN metastasis are difficult to radically resect at the salvage surgery, including this area in postoperative radiotherapy was considered an option.","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"70 2","pages":"E56-E60"},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A High Fibrosis-4 Index is Associated with a Reduction in the Estimated Glomerular Filtration Rate in Non-obese Japanese Patients with Type 2 Diabetes Mellitus. 高纤维化-4 指数与非肥胖的日本 2 型糖尿病患者估计肾小球滤过率降低有关。

Kobe Journal of Medical Sciences Pub Date : 2024-04-30 DOI: 10.24546/0100489395

Hiroyuki Inoue, Shun-Ichiro Asahara, Fumihiko Nakamura, Yoshiaki Kido

{"title":"A High Fibrosis-4 Index is Associated with a Reduction in the Estimated Glomerular Filtration Rate in Non-obese Japanese Patients with Type 2 Diabetes Mellitus.","authors":"Hiroyuki Inoue, Shun-Ichiro Asahara, Fumihiko Nakamura, Yoshiaki Kido","doi":"10.24546/0100489395","DOIUrl":"10.24546/0100489395","url":null,"abstract":"Liver fibrosis is associated with non-alcoholic fatty liver disease (NAFLD), and one of the most important risk factors for NAFLD is type 2 diabetes (T2DM). The Fibrosis-4 (FIB-4) index, a noninvasive liver fibrosis score, has been found to be useful for estimating liver fibrosis. Because individuals with non-obese NAFLD were recently reported to be metabolically unhealthy and have a higher risk of T2DM than individuals with obese NAFLD, we hypothesized that the clinical factors related to a high FIB-4 index would differ between non-obese and obese Japanese T2DM patients. Accordingly, we examined the relationship between clinical factors and the FIB-4 index in non-obese and obese Japanese patients with T2DM. We divided 265 patients into two groups by BMI level - a non-obese group (n = 149) and an obese group (n = 116) - and examined the correlation between the FIB-4 index and clinical parameters. Single regression analysis revealed that a high FIB-4 index was correlated with a reduction in the estimated glomerular filtration rate and hypertension in the non-obese group. Importantly, multiple regression analysis showed that only a reduction in the estimated glomerular filtration rate was significantly associated with a high FIB-4 index in the non-obese group. These results demonstrated that non-obese T2DM patients with a high FIB-4 index might be at risk of kidney dysfunction. Our findings may enable the more appropriate treatment of T2DM patients based on BMI level.","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"70 1","pages":"E39-E45"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11086634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genetic Rare Variants Affecting Multiple Pathways in Japanese Patients with Palindromic Rheumatism. 影响日本双相风湿病患者多条通路的罕见遗传变异。

Kobe Journal of Medical Sciences Pub Date : 2024-04-30 DOI: 10.24546/0100489391

Taketo Kawara, Koji Inoue, Shunichi Shiozawa, Kayo Osawa, Koichiro Komai

{"title":"Genetic Rare Variants Affecting Multiple Pathways in Japanese Patients with Palindromic Rheumatism.","authors":"Taketo Kawara, Koji Inoue, Shunichi Shiozawa, Kayo Osawa, Koichiro Komai","doi":"10.24546/0100489391","DOIUrl":"10.24546/0100489391","url":null,"abstract":"Palindromic rheumatism (PR) is a type of cryptogenic paroxysmal arthritis. Several genes may be involved in PR pathogenesis; however, conducting comprehensive case-control genetic studies for PR poses challenges owing to its rarity as a disease. Moreover, case-control studies may overlook rare variants that occur infrequently but play a significant role in pathogenesis. This study aimed to identify disease-related genes in Japanese patients with PR using whole-genome sequencing (WGS) and rare-variant analysis. Genomic DNA was obtained from two familial cases and one sporadic case, and it was subjected to WGS. WGS data of 104 healthy individuals obtained from a public database were used as controls. We performed data analysis for rare variants on detected variants using SKAT-O, KBAC, and SKAT, and subsequently defined significant genes. Significant genes combined with variants shared between the cases were defined as disease-related genes. We also performed pathway analysis for disease-related genes using Reactome. We identified 2,695,244 variants shared between cases; after excluding polymorphisms and noise, 74,640 variants were detected. We identified 540 disease-related genes, including 1,893 variants. Furthermore, we identified 32 significant pathways. Our results indicate that the detected genes and pathways in this study may be involved in PR pathogenesis.","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"70 1","pages":"E26-E38"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11086632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impacts of a Self-directed Social Resources Study Program on Negative Symptoms and Quality of Life in Schizophrenia Outpatients: A Randomized Controlled Trial. 自我导向的社会资源研究计划对精神分裂症门诊患者的消极症状和生活质量的影响：随机对照试验

Kobe Journal of Medical Sciences Pub Date : 2024-04-01 DOI: 10.24546/0100488377

Yuko Nishimura, Kayano Yotsumoto, Takeshi Hashimoto

{"title":"Impacts of a Self-directed Social Resources Study Program on Negative Symptoms and Quality of Life in Schizophrenia Outpatients: A Randomized Controlled Trial.","authors":"Yuko Nishimura, Kayano Yotsumoto, Takeshi Hashimoto","doi":"10.24546/0100488377","DOIUrl":"10.24546/0100488377","url":null,"abstract":"To clarify whether a self-directed study program on social resources improves negative symptoms, quality of life (QOL), and social participation among outpatients with schizophrenia. Eighty-six participants were randomly divided into intervention and control groups. In addition to the usual day programs, the intervention group participated in a self-directed study program on social resources once a week for eight weeks. The control group participated only in the usual day programs. Negative symptoms and QOL were assessed at baseline and post-intervention using the Positive and Negative Syndrome Scale (PANSS) and the WHO Quality of Life-BREF (WHOQOL-BREF), respectively. Social participation was also assessed. After the intervention, there were no significant differences in the PANSS negative symptoms and WHOQOL-BREF total scores between the two groups. Within-group, PANSS negative symptom scores significantly improved in the intervention group (p < 0.05), but not in the control group. The WHOQOL-BREF physical health subscale scores improved significantly only in the intervention group (p < 0.05). Social participation remained unchanged between the intervention and control groups. The results suggest that a self-directed study program on social resources may be useful for improving negative symptoms and physical QOL in outpatients with schizophrenia. The findings highlight the potential of such interventions to bridge the existing gap in psychosocial rehabilitation strategies for this population.","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"70 1","pages":"E15-E21"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11086633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

HELLP Syndrome at 20 Gestational Weeks Managed Using the Mississippi Protocol: A Case Report. 使用密西西比方案治疗妊娠 20 周 HELLP 综合征：病例报告。

Kobe Journal of Medical Sciences Pub Date : 2024-04-01 DOI: 10.24546/0100488386

Naohisa Masuko, Kenji Tanimura, Masayuki Tanaka, Akiko Uchida, Ryosuke Takahashi, Hitomi Imafuku, Masashi Deguchi, Yoshito Terai

{"title":"HELLP Syndrome at 20 Gestational Weeks Managed Using the Mississippi Protocol: A Case Report.","authors":"Naohisa Masuko, Kenji Tanimura, Masayuki Tanaka, Akiko Uchida, Ryosuke Takahashi, Hitomi Imafuku, Masashi Deguchi, Yoshito Terai","doi":"10.24546/0100488386","DOIUrl":"10.24546/0100488386","url":null,"abstract":"Hemolysis, elevated liver enzyme levels, and low platelet count (HELLP) syndrome is one of the most severe complications of hypertensive disorders of pregnancy. HELLP syndrome occurring before 22 gestational weeks (GWs) is extremely rare, and patients prevalently exhibit underlying maternal diseases or fetal abnormalities. Here, we report the case of a pregnant woman who had HELLP syndrome at 20 GWs without any obvious underlying maternal diseases or fetal abnormalities. A 38-year-old pregnant woman was referred to Kobe University Hospital from another hospital at 19 + 5/7 GWs for hypertension, proteinuria, generalized edema, and fetal growth restriction. She was diagnosed with partial HELLP syndrome according to the Mississippi classification at 20 + 2/7 GWs. The patient was managed following the Mississippi protocol, including intravenous dexamethasone, magnesium sulfate, and antihypertensive drugs. She received intensive blood pressure and laboratory data monitoring using an arterial line and additional treatments, including platelet transfusion, intravenous haptoglobin infusion, and human atrial natriuretic peptide. The pregnancy ended in an induced delivery at 20 + 3/7 GWs, and she was discharged without complications 10 days postnatal. We performed laboratory tests for diagnosing underlying diseases but identified no obvious underlying diseases. This report indicates that early and intensive treatment of patients with HELLP syndrome occurring before 22 GWs according to the Mississippi protocol may enable clinicians to complete pregnancy termination without maternal complications and provide useful information to clinical practitioners in perinatal medicine.","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"70 1","pages":"E22-E25"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11086631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sex Disparities in Applied Force on Maxillary Incisors Among Novices During Laryngoscopy Using a High-Fidelity Simulator: A Prospective Observational Study. 使用高保真模拟器进行喉内镜检查时，新手上颌切牙所受力的性别差异：一项前瞻性观察研究。

Kobe Journal of Medical Sciences Pub Date : 2024-02-29 DOI: 10.24546/0100486397

Yuko Ono, Kazuaki Shinohara, Jiro Shimada, Jun Sugiyama, Shigeaki Inoue, Joji Kotani

{"title":"Sex Disparities in Applied Force on Maxillary Incisors Among Novices During Laryngoscopy Using a High-Fidelity Simulator: A Prospective Observational Study.","authors":"Yuko Ono, Kazuaki Shinohara, Jiro Shimada, Jun Sugiyama, Shigeaki Inoue, Joji Kotani","doi":"10.24546/0100486397","DOIUrl":"10.24546/0100486397","url":null,"abstract":"Endotracheal intubation (ETI) is a common and crucial intervention. Whether the performance of ETI differs according to the sex of the laryngoscopist remains unclear. The aim of this study was to assess sex disparities in markers of ETI performance among novices using a high-fidelity simulator. This prospective observational study was conducted from April 2017 to March 2019 in a public medical university. In total, 209 medical students (4th and 5th grade) without clinical ETI experience were recruited. Of the 209 students, 64 (30.6%) were female. The participants used either a Macintosh direct laryngoscope or C-MAC video laryngoscope in combination with a stylet or gum-elastic bougie to perform ETI on a high-fidelity simulator. The primary endpoint was the maximum force applied on the maxillary incisors during laryngoscopy. The secondary endpoint was the time to ETI. The implanted sensors in the simulator automatically quantified the force and time to ETI. The maximum force applied on the maxillary incisors was approximately 30% lower in the male than female group for all laryngoscopes and intubation aids examined (all P < 0.001). Similarly, the time to ETI was approximately 10% faster in the male than female group regardless of the types of laryngoscopes and intubation aids used (all P < 0.05). In this study, male sex was associated with a lower maximum force applied on the maxillary incisors during both direct and indirect laryngoscopy performed by novices. A clinical study focusing on sex differences in ETI performance is needed to validate our findings.","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 4","pages":"E151-E158"},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11006240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spiritual Support to Improve Women's Mental Health after Miscarriage and Stillbirth: A Qualitative Study in Japan. 为流产和死产后妇女提供精神支持以改善其心理健康：日本的一项定性研究。

Kobe Journal of Medical Sciences Pub Date : 2024-02-08 DOI: 10.24546/0100486284

Yuko Endo, Izumi Saito

{"title":"Spiritual Support to Improve Women's Mental Health after Miscarriage and Stillbirth: A Qualitative Study in Japan.","authors":"Yuko Endo, Izumi Saito","doi":"10.24546/0100486284","DOIUrl":"10.24546/0100486284","url":null,"abstract":"Problem: Miscarriage and stillbirth can severely impact maternal mental well-being.Background: In Japan, local municipalities must prepare systems to provide mental and social-spiritual support to women after miscarriage or stillbirth.Objective: To elucidate what spiritually supports the mental health of women who have experienced miscarriages and stillbirths.Methods: This analysis included 25 women who had experienced miscarriage or stillbirth at least one month previously and participated in self-help group meetings at least twice. Data were collected from March 2020 to March 2021 using two narrative interviews and questionnaires.Findings: The mothers led their lives \"together\" with their children. They derived spiritual support from others, such as \"the presence of someone who is living now after having experienced anguish\" and \"others who acknowledge the presence of my child and me as a mother. \" Further elements of the support included \"resigning myself to face my grief\" and \"strong links to deceased children. \" While facing their grief by accepting that this anguish cannot be replaced [with anything else] and resigning themselves to reality, their bond to their child is strengthened.Conclusion: What women perceive as support after a miscarriage or stillbirth will be an important clue to care.","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"70 1","pages":"E1-E14"},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11086635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Expression of EGFR and p16 in Squamous Cell Carcinoma of External Auditory Canal. 外耳道鳞状细胞癌中表皮生长因子受体和 p16 的表达

Kobe Journal of Medical Sciences Pub Date : 2024-01-31 DOI: 10.24546/0100486232

Yasuyuki Kajimoto, Hirotaka Shinomiya, Natsumi Uehara, Masanori Teshima, Takeshi Fujita, Akinobu Kakigi, Yoshinori Imamura, Naomi Kiyota, Daisuke Miyawaki, Ryohei Sasaki, Hidehito Kimura, Ken-Ichi Nibu

{"title":"Expression of EGFR and p16 in Squamous Cell Carcinoma of External Auditory Canal.","authors":"Yasuyuki Kajimoto, Hirotaka Shinomiya, Natsumi Uehara, Masanori Teshima, Takeshi Fujita, Akinobu Kakigi, Yoshinori Imamura, Naomi Kiyota, Daisuke Miyawaki, Ryohei Sasaki, Hidehito Kimura, Ken-Ichi Nibu","doi":"10.24546/0100486232","DOIUrl":"10.24546/0100486232","url":null,"abstract":"The expression of EGFR and p16 in the external auditory canal squamous cell carcinoma (EACSCC) and their impacts on oncological outcomes were not well studied. Seventeen-one consecutive patients who were treated for EACSCC at Kobe University Hospital from 1995 to 2018 were enrolled in this study. The expression of EGFR, and p16 were evaluated and their impacts on oncological outcomes were statistically analyzed. Positive expression of EGFR was observed in 62 patients (87%). Strong positive expression of p16 were observed in 18 patients (32.4%), and weakly positive expression in 30 patients (42.3%), respectively. While the number of the patients with negative EGFR expression were limited, all the surgically treated patients with negative EGFR expression have been alive without disease. In the patients with T3 & T4a EACSCC, prognosis of the patients with positive p16 expression EACSCC tended to be better than those with negative p16 expression. These results suggest the clinical significance of EGFR and p16 expressions in the patients with advanced EACSCC to predict oncological outcomes.","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 4","pages":"E144-E150"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11006239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dietary Intervention for Control of Clinical Symptom in Patients with Systemic Metal Allergy: A Single Center Randomized Controlled Clinical Study. 控制全身性金属过敏患者临床症状的饮食干预：单中心随机对照临床研究》。

Kobe Journal of Medical Sciences Pub Date : 2024-01-31 DOI: 10.24546/0100486230

Reiko Mikajiri, Atsushi Fukunaga, Makoto Miyoshi, Noriaki Maeshige, Ken Washio, Taro Masaki, Chikako Nishigori, Ikuko Yamamoto, Akiyo Toda, Michiko Takahashi, Shun-Ichiro Asahara, Yoshiaki Kido, Makoto Usami

{"title":"Dietary Intervention for Control of Clinical Symptom in Patients with Systemic Metal Allergy: A Single Center Randomized Controlled Clinical Study.","authors":"Reiko Mikajiri, Atsushi Fukunaga, Makoto Miyoshi, Noriaki Maeshige, Ken Washio, Taro Masaki, Chikako Nishigori, Ikuko Yamamoto, Akiyo Toda, Michiko Takahashi, Shun-Ichiro Asahara, Yoshiaki Kido, Makoto Usami","doi":"10.24546/0100486230","DOIUrl":"10.24546/0100486230","url":null,"abstract":"Patients with eczema with a systemic metal allergy, such as nickel (Ni), cobalt (Co), chromium (Cr), and tin (Sn), should pay attention to symptomatic exacerbation by excessive metal intake in food. However, dietary intervention for systemic metal allergy can be difficult. In this study, we evaluated the effect of dietary intervention by a registered dietitian on clinical symptoms in patients with a systemic metal allergy. Forty-four patients with cutaneous symptoms who were diagnosed with a metal allergy were randomly assigned to the dietary intervention group (DI group, n = 29) by a registered dietitian or the control group (C group, n = 15). The DI group was individually instructed by a registered dietitian how to implement a metal-restricted diet and then evaluated 1 month later. Dermatologists treated skin lesions of patients in both groups. Skin symptoms assessed by the Severity Scoring of Atopic Dermatitis (SCORAD) index, blood tests, and urinary metal excretion were evaluated. The DI group showed decreased Ni, Co, Cr, and Sn intake (all P ≤ 0.05), and an improved total SCORAD score, eczema area, erythema, edema/papulation, oozing/crust, excoriation, lichenization and dryness after 1 month of intervention compared with before the intervention (all P ≤ 0.05). However, the C group showed decreased Ni and Sn intake and an improved oozing/crust score (all P < 0.05). It showed the effective reduction of dietary metal intake controls dermatitis due to a metal allergy. In conclusion, dietary intervention by a registered dietitian is effective in improving skin symptoms with a reduction in metal intake.","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"69 4","pages":"E129-E143"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11006241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0